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The Conundrum in Endoscopic Management of Duodenal Polyps: A Tertiary Cancer Center Experience

Expert Rev Gastroenterol Hepatol. 2022 Jun 10. doi: 10.1080/17474124.2022.2088508. Online ahead of print.


BACKGROUND: Endoscopic mucosal resection of duodenal polyps (EMR) is a challenging intervention. The aim of this study was to review the patient characteristics, techniques, procedure outcomes, adverse events, and recurrence of duodenal polyps.

RESEARCH DESIGN AND METHODS: Patients were included if they had pathologically confirmed non-ampullary duodenal polyps that were either sporadic or familial adenomatous polyposis syndrome-related and had received EMR with at least one follow-up EGD for surveillance. Descriptive statistics were employed to report findings.

RESULTS: A total of 65 patients underwent a total of 90 EMRs for duodenal polyps. The mean age was 65.4 years and 29 of the patients were female. Complete resection of the visible mass was achieved in 96.9% of cases. Endoscopic hemostasis was required in 18.5% of patients. Delayed bleeding occurred in 9%, and delayed perforations requiring surgical intervention in 2.2% of patients with no mortality. Surgery after EMR was needed in 12.7% of cases. Eleven (16.9%) patients had recurrent duodenal adenoma on follow-up EGD.

CONCLUSION: Duodenal polyps can be safely resected and have a notable recurrence rate. This is particularly true for adenomas, warranting post-resection endoscopic surveillance. The appropriate interval for post-resection surveillance for duodenal adenomas should be a focus of future study.

PMID:35687675 | DOI:10.1080/17474124.2022.2088508

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